Draft of July 24

**Observation 1: INHERENCY** 

**A.** 
**Millions of refugees are displaced in Sub-Saharan** **Africa** 

Ezekiel **Kalipeni**, pop. geographer at UI, and Joseph **Oppong**, Geographer at UNT, ‘**98**  
Soc. Sci. Med. Vol. 46, No. 12, pp. 1637±1653 
[http://www.ingentaconnect.com/content/els/02779536/1998/00000046/00000012/art10129] 

**__Africa__** today __faces__ **__a refugee crisis of unprecedented proportions. About three-quarters of the countries of__** **__Africa__** **__south of the__** **__Sahara__** **__have been affected profoundly as either the origin or destination of significant refugee movements. Due to__** the continuous and unpredictable nature of many of **__these conflicts__**, determining the exact number of refugees is difficult. Nevertheless, many experts __put__ **__the figure at several millions__**. According to the United Nations High Commission for Refugees, by 1995, Rwanda had produced 1.7 million refugees, Liberia 750 000, Somalia 450 000 Sudan and Angola 450 000 and 400 000 respectively, while Eritrea had produced 300 000 (UNHCR, 1993, 1995; United States Committee for Refugees, 1993, 1996). Such social figures usually exclude the many internally displaced people who migrate to safer places within their countries. Estimates show that between 25±30 million people worldwide have been forced to leave their homes and seek refuge elsewhere within the borders of their countries (Ferris, 1992; Cohen, 1996). **__Although systematic numbers for internally displaced persons are not readily available, estimates indicate that__** **__Africa__** **__has the greatest proportion of__** such **__refugees__**. 


**B.** 
**Current** **US** **aid policies ignore refugees,** **Somalia** **Proves** 

Kim **__Sengupata__**, staff writer for //The Independent//, 6-15-**__06__** 
http://findarticles.com/p/articles/mi_qn4158/is_20060615/ai_n16481103 

**__In a place the rest of the world prefers to forget, the ones who suffer the most are the poor. But along with the sheer, grinding poverty of__** **__Mogadishu__****__, the danger from endemic violence makes life even harder.__** **__Those forced to dwell in the vast, sprawling refugee camps__** of this battered city - there are **__280,000 of them, all living in some of the worst conditions in__** **__Africa__** **__- have received little or no aid in months.__** And in the one major hospital not controlled by the militias, the commonest treatment is for "wounds inflicted by weapons". **__After more than a decade of neglect, the capital of__** **__Somalia__** **__is suddenly back in the world's spotlight after the victory__** last week **__of Islamist fighters over United States-backed warlords. But the same conflict has meant that aid organisations deem the city to be too dangerous for relief operations.__** The shortage of funds is particularly hard for a country which has never benefited much from outside largesse. **__The US had backed the warlords, their allies in the "war on terror" against the Islamists, to the tune of millions of dollars, but such generosity has not been reflected when it comes to aid.__** 

**C.** 
**Refugees are outside of the normal spectrum of health services leaving them at a higher risk to contract HVI/AIDS** 

**__ICMH__**, International Center for Migration and Health, partner with the World Health organization, 3-28-**__01__** 

**__The risk and spread of HIV (as well as other diseases) has been linked to poverty in a complex dynamic. It is__** not __a__ question only the fact **__that the poor__** tend to have the worst housing, lack privacy, live in poor environmental conditions, have the worst jobs, high unemployment and **__have least access to health and social services. There is growing evidence that both migrants and__** 
**__refugees are more vulnerable to HIV/AIDS than people who do not move or who are not forced to move. In addition women and their children also make up the highest proportion of refugees__**. Men are soon targeted in conflicts or are conscripted into armies and militias leaving women and children (and to a lesser extent the elderly) to form a large part of the refugee populations everywhere. **__Migrants and refugees also fall outside of the normal spectrum of health and social services. Relief agencies have given little attention to preventing STIs or HIV/AIDS, nor have they developed much in terms of STI treatment. Migrants may be in situations where they are ineligible for and/or could not otherwise afford STI diagnosis and treatment.__**  

**D.** 

**Refugees are being denied health care in** **Africa** **and are calling for intervention** 

Mabutho **__Ngcobo__**, staff writer for the Nyasa Times, 3-31-**__07__** 
http://www.nyasatimes.com/Features/499.html 

**__Organizations representing Zimbabwean refugees in__** **__South Africa__** **__calling upon the government to intervene in challenges they face in accessing health care in the country__.** Gilbert Moyo, chairperson of the Zimbabwe Action Group (ZAG), says that as **__the number of the__** **__Zimbabwe__** **__refugees increase daily, they find themselves in a difficult situation where South African hospitals and clinics deny refugees medical care__****.** Moyo says this treatement is meted out not only to those who don’t have refugee status, but also to those who have the documents to prove that they are legal refugees in the country. “I speak from my own experience. If you go to the hospital and produce your section 22 paper - which permits you to reside in the country while still waiting for your refugee status, they tell you they can’t help you because you do not have the South African bar coded ID,” he said. Moyo says, Zimbabweans are not in South Africa by choice, and called on the government to intervene. “We would like to be in our country, we are not here because we like to be here, but we are here because of the problems we are faced with back home. Therefore, we would like the South African government to help, so that we can be treated like ordinary people.” Sazi Mpofu, 30, is one of the hundreds of illegal Zimbabwean refugees who arrived daily in South Africa due to the political and socio-economic crisis in Zimbabwe. He says although he is in the country illegally, he would like to see the government accommodating all refugees regardless of their status. “I want the South African government to know that we are here not because of our will. We love to stay in Zimbabwe because that is where we grew up, that is where we feel happy. We want the government to sit down and debate about this problem (not accessing health care). I don’t think there is going to be much of a problem if the government can allow asylum seekers to have access to health care,” he said. Sox Chikohweru of the Zimbabwe Diaspora Forum says it is sad that as Zimbabweans living in South Africa find themselves being refused access to health care, whereas South African freedom fighters were given all the help they needed when they were in foreign countries during the struggle against apartheid. He says as a freedom fighter himself, he remembers how his father used to help South African freedom fighters regardless of their refugee status. “I am a former freedom fighter myself. My father housed freedom fighters from South Africa in Zimbabwe. All that was needed was an MK card, not a refugee paper, not an asylum paper, not to visit the home affairs for the rest of your life in a foreign country. All that was needed was an MK card. “We are not asking for more, but we want them to look back and see how they were assisted by other countries and to also do the same for us, not only for us (Zimbabwe refugees), but all refugees in South Africa,” he said. Lauren Landau, Director of the Wits University-based, National Consortium for Refugees Affairs says the country’s Constitution allows refugees and asylum seekers access to health care. However, **__lack of knowledge of health professional about the rights of refugees as well as xenophobic discrimination against refugees make it difficult for refugees to access health care.__** “Refugees who are legally recognized by the South African government have the same rights to health care as any South African citizen or a permanent resident. People who are asylum seekers - those are the people who have applied to be refugees, but who have not yet been recognized - have limited rights and have to pay some fees. But everyone in South Africa whether they are asylum seekers or refugees have rights to emergency or life saving care. “**__There is also a real problem of health care professionals who are not aware of the rights that migrant refugees have to the services. There are also instances where there is outright discrimination, where people are told to go away, that ‘these are our resources. We do not have enough resources for foreigners, for people who are not South African’,” he added. Meanwhile, the health department spokesperson__**, Sbani Mngadi says, “Iif there is a need for an emergency health care, we do not deny anyone access. We can then deal with the illegal issues in conjunction with the department of Home Affairs. But **__we need to make it clear that people who have refugee status, permanent and non-permanent residents, need to get same level of health care__.”** 


**Observation 2: HARMS** 

**Advantage 1: DISEASE** 

**A.** 
**Refugee camps are in dire need of health assistance to prevent the spread of diseases to the rest of the world.** 

Ezekiel **Kalipeni**, pop. geographer at UI, and Joseph **Oppong**, Geographer at UNT, ‘**98**  
Soc. Sci. Med. Vol. 46, No. 12, pp. 1637±1653 
[http://www.ingentaconnect.com/content/els/02779536/1998/00000046/00000012/art10129] 


**__Current disease outbreaks in refugee camps that are a major public health concern include yellow fever, cholera, Ebola, Lassa fever and tuberculosis.__** Between November and December 1996, there was an outbreak of yellow fever in Liberia which affected 356 people with nine confirmed deaths (World Health Organization, 1996). **__Lassa fever__**, an anthropozootic disease which **__causes fever, hemorrhaging, vomiting, chest pains and low blood pressure, and kills within seven days, has surfaced in__** **__Sierra Leone__****__, with a case fatality of 25%__** (Electronic Mail and Guardian, 1997). **__The outbreak was attributed to the rapid growth of rats,__** 
**__the host, when war forced many people to abandon their villages. Overcrowding increases the risk of human transmission__**__.__ Another troubling and rapidly growing new disease is **__AIDS__** which **__has reached epidemic proportions in parts of central__** **__Africa__** **__such as__** **__Rwanda__****__,__** **__Uganda__****__,__** **__Zaire__** **__and__** **__Burundi__****__, a zone of endemic conflict and refugee flows__**__.__ Other diseases that plague refugees include dysentery, measles, pneumonia, and meningitis. Besides, due **__to the breakdown of health services, such diseases as plague, diphtheria, cholera, yellow fever, and dengue are re-emerging as public health problems.__** 
Compounding this is the development and spread of strains of bacteria resistant to antibiotics making many infections difficult and expensive to treat (Hughes and Tenover, 1996). For example, the strain of cholera responsible for the massive cholera outbreak on the Rwanda-Zaire border in 1994, was highly resistant to antibiotics normally recommended for treating cholera, such as tetracycline (World Health Organization, 1994). Factors that increase the threat from outbreaks of these highly pathogenic viruses are international commerce and travel, limited experience in diagnosis and case management, limited knowledge of the natural source (natural nidus), the importation of non-human primates and the potential the viruses have to evolve rapidly, making treatment difficult (Feldmann et al., 1996; Pimentel et al., 1997). **__Increasing globalization means diseases travel faster around the world with increasing freedom.__** **__This puts the whole world at risk of virulent newly emerging viruses.__ __The key to preventing such an outbreak is finding the pathogens where they are and destroying them. This is not feasible in the anarchist environments that produce refugees.__** 


**B.** 
**Poor santiation, contaminated food and water, and overcrowding make Refugee camps vectors of disease.** 

Ezekiel **Kalipeni**, pop. geographer at UI, and Joseph **Oppong**, Geographer at UNT, ‘**98**  
Soc. Sci. Med. Vol. 46, No. 12, pp. 1637±1653 
[http://www.ingentaconnect.com/content/els/02779536/1998/00000046/00000012/art10129] 

**__The relationship between economic conditions and refugees__** **__may not be straight forward__** or even direct. An important question is how poverty begets conflict and refugees. Here there **__is a need to look carefully at the distribution and access to resources. Disputes may arise among national groups from efforts to preserve or advance the standing of one group at the relative expense of others__** (UNHCR, 1993, p. 15). Disputes concerning the distribution of resources during general economic decline are the most politically explosive. Such economic declines may be internally or externally induced. For example, during the past ten years African countries have witnessed the imposition of structural adjustment programs which have had extensive implications for African economies for better or for worse. Structural adjustment programs have meant 
the devaluation of currencies which makes exports cheaper to foreign buyers but imports more expensive to local masses. Government salaries have been frozen to reduce deficits, agricultural prices have 
been liberalized, and subsidies to urban consumers have been eliminated (Gordon, 1996). While the 
middle and lower classes have experienced the short end of the economic downturn due to the implementation of these foreign imposed adjustments, the very rich have gotten richer over time (Gordon, 1996). **__The result is the creation of animosities between different income groups and/or ethnic tensions depending on which group controls access to the resources.__** Indeed during the 1980s, there were numerous ``food riots'' in many African cities as a response to the unfair policies of structural adjustment (Kalipeni, 1992). Excellent examples of how the 3 sets of interrelated causal factors discussed above interact with one another can be readily found in Sudan and Ethiopia as described in depth by Keen (1994) and Kloos and Zein (1993). **__The violence that usually produces refugees has complex and multiple direct and indirect effects on health and disease. First, it disrupts livelihoods including agricultural production and food supplies leading to famine and widespread malnutrition. Health service provision is similarly affected as health workers flee for their lives or disruption of medical supplies creates shortages resulting in closure of health facilities. Second, expenditure on war usually results in drastic reductions in health expenditure and health services at a time of increased demand for health services. Third, fleeing the prevailing anarchy of war puts refugees into refugee camps- an environment where poor sanitation, contaminated food and water, and overcrowding make suffering and disease bloom.__** The combined effect of these is escalated morbidity and mortality frequently from infectious and vaccine-preventable diseases such as measles, especially during the initial period before the international community has responded in a commensurate manner. 

**C.** 
**Global Surveillance fails without proper Health Care assistance for the growing refugee population, AIDS will spread globally and result in extinction.** 

Ezekiel **__Kalipeni__**, pop. geographer at UI, **__and__** Joseph **__Oppong__**, Geographer at UNT, ‘**__98__**  
Soc. Sci. Med. Vol. 46, No. 12, pp. 1637±1653 
[http://www.ingentaconnect.com/content/els/02779536/1998/00000046/00000012/art10129] 

As discussed in this paper, **__Africa__** **__today faces an unprecedented and growing refugee crisis.__** The political ecology of the refugee crisis and patterns of refugee flows suggest a redistribution of populations along ethnic and religious lines and perhaps an unraveling of the arbitrary political boundaries imposed under colonialism. Nevertheless, the burden imposed on Africans by the wanton violence, torture, rape and landmines is simply devastating and demands immediate action. **__While imposing many unmet health care needs, political violence disrupts and impedes livelihood and provision of health services producing an endless cycle of poverty, misery, sickness and death.__** Unfortunately, such stories are spreading with no end in sight. **__The AIDS pandemic and outbreaks of Ebola emphasize the global implications of local problems__** and remind us that we live in a global village. Without proper surveillance, __local__ **__outbreaks of infectious diseases threaten all humankind__****. __Clearly, global surveillance__** for example as advocated by the CDC**, __is not possible in__** the anarchist, landmined, **__refugee environments of__** **__Africa__****__.__** 


**D.** 
**Refugee flow guarantees epidemic outbreaks, poor living conditions, and health problems that only health care could end.** 

Ezekiel **__Kalipeni__**, pop. geographer at UI, **__and__** Joseph **__Oppong__**, Geographer at UNT, ‘**__98__**  
Soc. Sci. Med. Vol. 46, No. 12, pp. 1637±1653 
[http://www.ingentaconnect.com/content/els/02779536/1998/00000046/00000012/art10129] 

Using a political ecology framework, this paper examines the geography of exile and refugee movements and the associated implications for re-emerging and newly emerging infectious diseases. Drawing upon specific examples such as Rwanda, Zaire, Liberia, Mozambique and others, the paper critically discusses the push–pull forces in such refugee movements and the political ecologic environments such conflicts create. Of particular concern are perhaps the tragic health consequences the refugee crisis has spawned and is likely to engender in the future. For example, the indiscriminate laying of landmines and guerilla warfare activity has created what has been termed “green famine” and food shortages in the presence of reasonably fertile land as farming is suspended and people abandon their fields in search of “safe havens”. **__Overall disruption of health service delivery and especially preventive care means that routine under-five clinics, immunization programs and prenatal care are no longer available leading to high infant and maternal mortality rates. Unsanitary conditions of refugee camps invariably result in the outbreak of infectious diseases such as cholera. We argue in this paper that there is great potential of something more virulent than cholera and Ebola emerging and taking a big toll before being identified and controlled. Refugee camps are fertile grounds for outbreaks of re-surging old scourges and newly emerging infectious diseases (e.g., HIV, tuberculosis, cholera, Ebola, “flesh eating” bacteria, drug-resistant malaria, etc.)__**__.__ We conclude by noting that once these diseases are out in the public they diffuse rapidly as they know no boundaries, a fact that has a direct bearing on global health. 

**E.** 
**Local diseases of African refugee camps become global endemics due to global interconnectedness.**  

Ezekiel **Kalipeni**, pop. geographer at UI, and Joseph **Oppong**, Geographer at UNT, ‘**98**  
Soc. Sci. Med. Vol. 46, No. 12, pp. 1637±1653 
[http://www.ingentaconnect.com/content/els/02779536/1998/00000046/00000012/art10129] 


What **__we are witnessing in refugee camps in__** **__Africa__** is **__the interplay of political or social forces and biophysical processes within the political ecology framework. Conflict, a product of political forces that are locally or internationally engendered, forces people to run from their stable environments and homes and relocate into natural nidal zones within which a previously unknown disease such Ebola exists and circulates in animal reservoirs and hosts.__** **__The move__** into such natural nidal zones **__brings humans into contact with a new disease which might find the unsanitary refugee camp conditions a fertile ground for transmission and quite often results in severe outbreaks. Other diseases__** mentioned above **__also find a fertile environment in the unsanitary camps.__** In short, __political or__ **__social forces interact with biophysical or adverse environmental conditions to produce disease and suffering, while increasing globalization puts the whole world at risk of such infections.__** In recognition of the global nature of the threat, **__th__**__e__ World Health Organization **(__WHO) has asserted that emerging infections represent a global threat that will require a coordinated, global response__** (World Health Organization, 1995). To emphasize the urgency of the situation, WHO declared ``Emerging Infectious Diseases, Global Alert & Global Response'' as the theme for the 1997 World Health Day (World Health Organization, 1997). Similarly, the United States Centers for Disease Control (CDC) has stressed that surveillance is critical to an effective defense against new and reemerging infectious diseases but current international monitoring of such diseases is fragmentary and inadequate (Centers for Disease Control and Prevention, 1994). To be effective, disease surveillance requires political stability, communications infrastructure and stable health departments. In the zones of conflict in Africa, these conditions are not possible, and disease pathogens proliferate. In effect, **__the recent emergence of Ebola and Lassa fever and the importation from African countries of tropical diseases by immigrants, refugees and tourists remind us that the world is increasingly interdependent and that health and survival will always be challenged by new pathogens. These outbreaks also illustrate the global implications of local problems__** 
**__and provide evidence of the disruption of commerce and industry that can result from the occurrence of infectious disease outbreaks__** (Hughes and Tenover,1996). Thus, **__from a political ecology point of view,__** 
**__a local problem can easily translate into a global problem__**. In fact, **__until lasting solutions are found__** the refugee-producing, landmine-proliferating conflicts and violence in Africa__,__ **__the world will continue to be at risk of highly virulent infectious diseases.__** 




**Advantage 2: Refugee Leadership:** 

**A.**  
**The International refugee care regime is deteriorating.** 

M. **Lynch**, Director of Research for Refugees International, May 20**04**, Forced Back, http://www.reliefweb.int/rw/lib.nsf/db900SID/LHON-622KA4/$FILE/refintl_forced_back_may2004.pdf?OpenElement 

**__Access to asylum can mean the difference between life and death. Yet asylum policies around the world have become increasingly restrictive.__** **__Every day individuals are refused admission into and expelled from countries without having access to fair and effective status determination processes__**__.__ Some are returned to countries where their human rights cannot be guaranteed. **__Despite existence of international agreements, states often fail to protect refugees, fearing threats to national security, domestic destabilization, infiltration by armed groups or traffickers, depletion of scarce resources, and the influx of more refugees__**__.__ Sometimes xenophobia or racism determines the states’ response. **__International agencies also fall short in their protection operations.__** 



**B.** 
**US international support for the care of refugees is now crucial in** **Africa-** **US aid with Indochinese refugees proves.** 

Phillip **__Peters__**, Former Member on the Council of Foreign Relations Task Force, 7-31-**__97__** 

**__According to the UN, the number of persons in need of protection worldwide has grown from 17 million in 1991 to about 26 million today. The hopes that end of the Cold War would reduce the world's regional conflicts and brushfire wars have not panned out. Instead, regional and ethnic conflict have increased__**. Moreover, as a new State Department report documents, the suppression of religious freedom continues in many parts of the world, and in places such as Russia, there is a resurgence of repression against Christians and other believers by the Russian Orthodox Church and the state. As Representative Frank Wolf has noted, "Religious persecution -- and especially the persecution of Christians -- did not dissipate with the Cold War. It has gotten worse while the world and the United States have turned their efforts elsewhere**." __In many conflictive regions, refugees are both a symptom of instability and a potential cause of further instability. In these areas,__** **__U.S.__** **__support for international efforts to care for and resettle refugees is an investment in the resolution and prevention of conflict.__** The key to securing humane treatment for the maximum number of refugees often lies in demonstrating that the burden will be shared among the international community. **__In the 1970's, our acceptance of Indochinese refugees provided just such a demonstration, and helped save the lives of thousands of boat people. Without American leadership -- which brought the eventual resettlement of over 1.2 million Indochinese in the U.S. -- Australia and New Zealand might not have accepted boat people for resettlement, and Malaysia and the Philippines might not have established camps that provided temporary safe haven.__**  



**Scenario 1: Cycle of Conflict.** 

**C.** 
**Refugee flows are the root cause of ethnic and internal conflicts in** **Africa****.** 

**Stephen Metz,** 2-**00**, “Refining American Strategy in Africa”, p. 12-13 
Carlisle-www.army.mnil/usassi/ssipubs/pubs2000/refining/reing.com 

**__While traditional, cross-border, state-on-state warfare is rare in__** **__Africa__****__, internal conflict__** arising from a struggle for control of the government is common and thus **__constitutes a major source of instability and insecurity__**__.__ In 1999, the Democratic Republic of Congo, Sierra Leone, Sudan, Congo, Guinea Bissau, Rwanda, Somalia, Burundi, Uganda, and Angola were all wracked by internal war. Other long-standing conflicts were in hiatus but capable of exploding at any time. **__At the root is the struggle for power and resources, but ideology or ethnicity was often used to mobilize support and define “us” and “them.” What makes these internal conflicts particularly debilitating is the tendency for them to become internationalized. Refugee flows away from areas of violence can destabilize neighboring states whose ability or willingness to protect and sustain the refugees is often limited.__** **__By 1998,__** **__Africa__** **__was home to approximately 8.1 million refugees (out of a world total of 22 million).37 Even internal refugee flows can cause a breakdown of basic services and great suffering.__** In Angola, for instance, a million people have fled fighting between the government and UNITA, crowding into already-overburdened cities and threatening the country with a humanitarian disaster. 38 **__When refugee problems are not solved quickly, they can eventually spark wider destabilization.__** **__It was largely the children of refugees who had fled Rwanda for Uganda in 1959 and 1961 who formed the insurgency that ultimately took power in Kigali__**__.__ 

**D.** 
**Refugee flows are the root cause of ethnic, communal, and religious conflicts.** 

**__Loescher__**, Senior Fellow for Forced Displacement and International Security for the International Institute for Strategic Studies, and Loescher, Professional Writer and Instructor, 19**__94__** (Gil and Ann, "The Global Refugee Crisis," pg. 24-6) 

**__The end of the Cold War has also revealed the scope and intensity of specific local tensions around the world.__** The most common form of warfare in the developing world and Eastern Europe in the 1990s is internal conflict, fueled by the increasing availability of modern weaponry, sharp socioeconomic inequalities, and human rights abuses. **__Contemporary refugee movements are likely to be the result of ethnic, communal, and religious conflicts__**. Ethnic angtagonisms between Armenians and Azeris, Hutus and Tutsis, Tamils and Sinhalese, Serbs and Croatians and Muslims, and Palestinians and Israelis illustrate the local roots of many refugee exoduses. **__Internal wars have been fought not only by military means but by preventing international aid from reaching people living in conflict areas.__** **__In such situations, the international community is frequently unable to assist or intervene and the ability of governments or international organizations to influence the behavior of warring factions is limited or virtually nil.__** For example, in the former Yugoslavia, UNHCR staff not only distribute relief but also try to restrain ethnic cleansing and protect human rights. In the face of cynical manipulation by all the protagonists to the conflict, however, these humanitarian efforts have been stopgap measures only. **__One of the principal lessons of__** the **__conflict__** in Bosnia **__is that the humanitarian mandate of UNHCR cannot be viewed as a satisfactory substitute for wider-ranging political solutions.__** 
**E.** 
**Refugee spillover leads to disease epidemics, global arms races, a harbor for terrorism, and the beginning of a new era of civil war.** 

Gregory F. **__Treverton__**, head of the RAND Corporation, one of the world’s leaders in providing professional services and technology to the world, 5-24-**__05__** 
http://siteresources.worldbank.org/INTAMSTERDAM/Resources/GregTreverton.pdf 

News **__stories often emphasize the plight of refugees__** and immediate victims of internal conflicts. **__But the costs are broader and deeper and have a longer time trajectory__. __The United Nations High Commission for Refugees is currently assisting more than 5 million internally displaced persons__** as a result of internal conflicts. Many millions more are affected. Collier shows that conflicts typically lower incomes by around 15 percent, implying that about 30 percent more people are living in absolute poverty as a result of conflict. **__Health deteriorates as a combined result of immediate conflict, migration and lower income__**. And the end of conflict does not end the costs arising from it. __Many **of the economic costs, such as high military expenditure and capital flight, persist for years after the conflict. So, too, do worsened health outcomes**__**.** The second ring of suffering afflicts neighbors. **__Even when the wars themselves don’t spread, their refugees often do. The refugees spread infections; for example, for every 1,000 international refugees a country receives, that host county sees, on average, around 1,400 additional cases of malaria.12 Neighboring countries suffer reductions in economic growth, and they may feel impelled to increase their defense spending in a chain reaction of local arms races.__** The costs of an internal conflict to its neighbors as a group can often be of the same order of magnitude as the costs to the country concerned. The third set of spill-over costs stretches across the globe, and bears on the rich countries as well. Some of these spill-over costs are tangible. As General Shalikashvili noted, when other countries are moved to intervene in a conflict, in military or humanitarian terms, that generates a direct set of costs. Other costs are less tangible. **__If some combination of poverty, state failure, and internal conflict produces compliant states or territory beyond the control of states, those locations may become harborers of drug traffickers or terrorists. For instance, 95 percent of the global production of hard drugs occurs in countries with civil wars, and major supply routes run through conflict__** __**territories.**__ Taliban-controlled Afghanistan played host to Al Qaeda, even though most of its members were not Afghans; the hosting was partly voluntary, partly the compliance of a failed or weakened state. Global pandemics may spread from poor countries to rich ones. In this case, the role of conflict is perhaps less important that the roles of sheer poverty and poor health care. **__But conflict is often a catalyst for the emergence of cholera and other epidemics, and the aftermath of conflict, even the return of refugees, can lead to the rapid spread of HIV/AIDS.__** 


**F.** 
**U.S.** **leadership on refugee issues is key to prevent and contain global waves of conflict and refugee flows.** 

**__Loescher__**, Senior Fellow for Forced Displacement and International Security for the International Institute for Strategic Studies, and Loescher, Professional Writer and Instructor, 19**__94__** (Gil and Ann, "The Global Refugee Crisis," pg. 24-6) 

**__The United Nations is still the only body capable of managing many of the complex global problems of the post- Cold War era__**__.__ The international community needs to take advantage of both the structural and technical reforms that have occurred within the UN system and the higher expectations for the United Nations that now exist. Events in Iraq, in ex-Yugoslavia, and in Somalia, however, have demonstrated that the United Nations is not a separate entity capable of imposing order by itself, nor is it capable of achieving success in every endeavor. The United Nations is the sum of its member states, and US and Western leadership in invigorating multilateral program is a key factor if the United Nations is to achieve optimum results. **__The United States is still the only nation whose leadership most other nations are willing to follow, and it is the country most capable of setting up all sorts of measures to direct international efforts toward a constructive goal. Therefore, American leadership is vital in galvanizing collective efforts to resolve many of the complex humanitarian problems of the post-Cold War era. Without active__** **__U.S.__** **__involvement, the international community would be limited to reactive damage control measures in the event of humanitarian crises. A failure by the United States__** and its allies **__to increase the capacities of the United Nations at this time would almost inevitably lead to a breakdown in international security, to costly military interventions to restore order, and to further needless drains on aid programs__** to deal with war-caused famines or refugee movements in the future. Not since 1945 has the United States and the international community been presented with such an opportunity to make substantial progress on many political and humanitarian issues. That opportunity should now be seized. 

**G.** 
**Ethnic conflicts spillover into international affairs becoming a major source of global insecurity resulting in several wars, the breakup of the** **Soviet Union** **proves.** 

David **__Carment__**, NPSIA at Carleton University **__and__** Patrick **__James__**, Department of Political Science at ISU, **__No Date Given__** http://http-server.carleton.ca/~dcarment/papers/escalati.html 

**__Increasing concern in the early 1990s over the negative impact of the end of the Cold War strengthened fears that the break-up of the__** **__Soviet Union__** **__would unleash a barrage of lethal ethnic wars and state failures. The resulting instability, it was argued, would displace millions of people and create a wake of social upheaval unparalleled in this century. The idea of an impending global crisis became firmly rooted in both the belief that ethnic conflicts were becoming a major source of global insecurity and in the assumption that the international community was ill-equipped to deal with this new source of insecurity. A cursory glance at the range of disputes, violent or otherwise, supports the impression that ethnic conflicts have been multiplying at an exponential rate.__** By 1993, for example, there were at least 48 existing or potentially violent conflicts in progress. These included Romania, Mauritania, Rwanda-Burundi, Senegal, Togo, Nigeria, Kenya, Papua New Guinea, Fiji, Algeria, Egypt, China, Bhutan, Brazil, Mexico, India, Kosovo, Albania, Greece, Bulgaria, East Timor, the Republic of Macedonia and Tadjikistan. By 1996, however, the total number of serious conflicts (those with 1000 battle-field fatalities or more) had decreased to pre-Cold War numbers either because of military defeat, negotiated settlements, government reform or some form of concerted third party intervention. The most notable of these successes are the Bosnian, Philippine Moro and Northern Ireland conflicts. Nevertheless, public concern about the extreme cases - those involving a combination of widespread violence, state failure and spillover to neighbouring states - remains at the forefront in the development of ethnic conflict analysis. For every civilized divorce Czech-style, analysts note, there have been at least two dozen more armed conflicts. In extreme cases **__ethnic conflicts, violence and spillover appear to be inextricably intertwined and unstoppable__**. For example, at the height of the slaughter in Rwanda in 1994, an estimated 8,000 people were systematically being butchered per day. An estimated total of 850,000 Tutsis and moderate Hutus were killed over a four month period in 1994. **__In the fall of 1996 an estimated one million warrior refugees and survivors of the__** **__Rwanda__** **__genocide were caught in a "out of control" interstate ethnic crisis involving the armies of__** **__Rwanda__****__,__** **__Zaire__** **__and paramilitary Tutsi ethnic militias. The crisis now threatens to engulf all of__** **__Central Africa__** **__and the__** **__Great Lakes__** **__Region__****__.__**  

**Scenario 2: Economic Failure** 

**H.** 
**Violent Political Conflict, Social Polarization, and economic decline are effects of uncontrolled ethnic conflict** 

John M. **__Richardson Jr. and__** Shinijee **__Sen__**, professors at the School of International Service at American University, **__‘96__** 
http://www.american.edu/jrich/Richardson.ethnic.confl.html 

Proximate causes of ethnic conflicts can be easily identified . In typical scenarios, leaders of a dominant ethnic group gain office and then use state institutions to distribute economic and political benefits preferentially to their ethnic brethren. Discrimination against subordinate group members, often portrayed as less deserving human beings, accompanies this preferential treatment. When force is needed to impose discriminatory practices and quell subordinate group resistance, it is exercised by police officers and soldiers recruited almost exclusively from the dominant group, who often view themselves as "ethnic soldiers" In democratic societies, a dominant group that is a majority often uses its voting power to entrench discriminatory practices by legal or quasi legal means. When a dominant group is the minority, it typically imposes discriminatory policies by force although, as in South Africa, cosmetic democratic institutions may legitimize discrimination. Democracy alone cannot ensure ethnic harmony. Instead, it may allow freer expression of ethnic antagonisms and legalized persecution of minorities.**__Subordinate group members may endure discrimination for an extended period of time; however a sense of shared deprivation strengthens identification with their group, providing a basis for political mobilization along ethnic lines.__** Before inter-group relations polarize, "moderate" subordinate group leaders often seek a modus vivendi with their dominant group counterparts. In some nations, notably Malaysia, leaders have been able to work out a relatively stable accommodation, involving trade offs between political and economic power. More **__typically pleas of subordinate group leaders for accommodation are ignored or judged to be "politically infeasible" by dominant group leaders. The more severe and inflexible the discrimination, the more probable that subordinate group members will become radicalized. As radicalization proceeds, subordinate group members shift support from moderate to militant leaders__**__.__ Militant leaders form disciplined paramilitary organizations committed to violent force as the only feasible strategy for ending discrimination. **__An escalating spiral of violent political conflict, ethnic polarization, social disintegration and economic decline is the most probable outcome. This scenario has been all too prevalent in developing nations__** and now in former Communist nations. Ethnic conflicts, once they become violent, are exceedingly difficult to resolve. Indeed, some observers argue that separating protagonists physically is the only practicable solution. Since members of dominant and subordinate groups are often economically interdependent and physically intermingled, however, this "solution" may be impossible or only slightly less tragic than protracted conflict. 

**I.** 
**Ethnic conflict is the cause of insufficient national growth, and a failing economy** 

William **__Easterly__**, prof of Economics at NYU and joint with Africa House, **__‘00__** 
http://www.cgdev.org/doc/expert%20pages/easterly/easterly_ethnic_conflict.pdf 

**__Easterly and Levine__** [1997] **__document an adverse effect of ethnolinguistic fractionalization on income, growth, and economic policies. They offer this as an explanation for__** **__Africa__****__’s poor growth performance.__** Alesina, Baqir, and Easterly 1999 find that more ethnically diverse cities and counties in the US spend less on public goods. Goldin and Katz 1999 find lower public support for higher education in states with more religious - ethnic heterogeneity. Goldin and Katz 1997 likewise find lower high school graduation rates in states that had higher religious-ethnic diversity. Miguel 1999 likewise finds lower primary school funding in more ethnically diverse districts in Kenya. Mauro 1995 and La Porta, Lopez de Silanes, Shleifer and Vishny 1998 find that ethnic diversity predicts poor quality of government services. Mauro 1995 and Annett 1999 finds that **__linguistic or religious diversity leads to greater political instability__, __which__** Annett finds in turn **__leads to higher government consumption__**__.__ Alesina, Baqir, and Easterly 1999b find a link from ethnic diversity to bloated government payrolls in US cities. Rodrik 1999 noted that ethnically polarized nations react more adversely to external terms of trade shocks. Svensson 1998 finds that more **__foreign aid proceeds are diverted into corruption in more ethnically diverse places.__** Knack and Keefer 1997 find that ethnic homogeneity raises “social capital” or “trust,” which in turn is associated with faster growth and higher output per worker. Alesina and La Ferrara 1999 find that higher ethnic heterogeneity makes participation in social clubs less likely in the US, which is consistent with the idea that there is not much association across groups. Adelman and Morris 1967 also noted that “**__cultural and ethnic heterogeneity tend to hamper the early stages of nation-building and growth.”__**



**J.**  
**Algeria** **proves that economic downfalls are like a ticking time tomb that is capable of destroying regions while restarting the cycle of refugees again.** 

Abdelaziz **__Testas__**, professor of economics at Yang-En university in China, December ‘**__02__** 
http://www.informaworld.com/smpp/content~content=a713999754~db=all 

European attitudes towards Algeria's civil conflict have accorded priority to containing violence through tolerance of the government's strategy of eradicating the Islamist threat by military means. This approach, as shown by this study, has achieved rather limited success as it is based on the simplistic view that the conflict is an Islamist-military war that was the consequence of the interruption of the 1991 election process to keep the Islamists from power__. **The fact that the crisis is inherently economic and that this suspension is mainly a result of it has largely been ignored.**__ **__It is thus concluded that without new thinking on behalf of the European Union that puts the economy at the centre of an understanding of the crisis in Algeria__**, the current strategy can only deal with the symptoms. **__Algeria__** **__will remain a time-bomb that is capable of generating huge waves of migration and regional destabilization.__**

**Observation 3: SOLVENCY** 

**A.** 
**US Refugee Leadership is critical for others to follow.** 

Phyllis **Oakley,** former assistant secretary of state for intelligence and research, 3-28-**95**  
dosfan.lib.uic.edu/ERC/populations/press_releases/950328.html 
**__As the numbers of refugees and conflict victims in__** **__Africa__** **__have grown, so have our requests for appropriations to provide a fair share of budgetary support for international and non-governmental organizations which are our implementing partners in ensuring protection and assistance for these refugees.__** We believe that in large scale refugee crises such as Rwanda and Bosnia, it is necessary for the UN to take overall responsibility for coordinating the humanitarian effort. This is also cost-effective, as the U.S. support is typically 20 to 25 percent. **__The American people, through the Congress, have always been extremely generous and forthcoming on humanitarian assistance for refugees. We are grateful for that support which enables the__** **__United States__** **__to play an important leadership role in stimulating an adequate international response to humanitarian needs__. __Time and again I have seen other players look to us to take a first step -- for example on the critical question of security in Rwandan refugee camps. Rather than resist when others thrust us into leadership, we should be proud that we have been able to provide that leadership to maintain a multilateral framework for refugee assistance. In this framework, the USG is but one of many who have responsibility for action in behalf of the world's refugees and conflict victims__**  
**B. Humanitarian efforts through Health care show that the** **US** **is atop the refugee leadership rung with vocal support from several other countries.** 

Bruce **__Nichols__**, staff writer for Orbis (Company that specializes in international relations), **__‘95__** 
http://findarticles.com/p/articles/mi_m0365/is_n2_v39/ai_16955379/pg_3 

Both sets of pressure -- to help innocent people and to punish vile governments --- play into current U.S. humanitarian policy. **__The__** fall 1993 **__speech by national security adviser__** **__Anthony__** **__Lake__****__, "From Containment to Enlargement," set a humanitarian agenda" as one of four key elements in a new definition of__** **__U.S.__** **__foreign policy. Such goals are not new to__** **__U.S.__** **__foreign policy, but to have them elevated so visibly in the context of__** **__Somalia__****__,__** **__Bosnia__****__,__** **__Iraq__****__, and__** **__Rwanda__** **__suggests at first glance wider__** **__U.S.__** **__and international support for "humanitarian intervention."__** However, **__Lake explicitly noted that humanitarian efforts abroad serve a public relations role__** ("nurture the American public's support for our engagement abroad") and an economic role ("stimulate democratic and market development"). At no point did Lake present humanitarian ends as a moral obligation; he stated only that they play an 'important supporting role."(1)The U.S. government has put its cards on the table: humanitarian policy must be related to broader policy goals that are, in their essence, political. **__If those goals happen to support wider rationales for humanitarian intervention and their internationalization, as indeed they are liable to, one would think__** that Tronto, Millett, and **__many of the vocal supporters of humanitarian efforts would approve.__**  

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**C.**
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**Refugees are being denied health care in** **Africa** **and are calling for intervention** 

Mabutho **__Ngcobo__**, staff writer for the Nyasa Times, 3-31-**__07__** 
http://www.nyasatimes.com/Features/499.html 

**__Organizations representing Zimbabwean refugees in__** **__South Africa__** **__calling upon the government to intervene in challenges they face in accessing health care in the country__.** Gilbert Moyo, chairperson of the Zimbabwe Action Group (ZAG), says that as **__the number of the__** **__Zimbabwe__** **__refugees increase daily, they find themselves in a difficult situation where South African hospitals and clinics deny refugees medical care__**. Moyo says this treatement is meted out not only to those who don’t have refugee status, but also to those who have the documents to prove that they are legal refugees in the country. “I speak from my own experience. If you go to the hospital and produce your section 22 paper - which permits you to reside in the country while still waiting for your refugee status, they tell you they can’t help you because you do not have the South African bar coded ID,” he said. Moyo says, Zimbabweans are not in South Africa by choice, and called on the government to intervene. “We would like to be in our country, we are not here because we like to be here, but we are here because of the problems we are faced with back home. Therefore, we would like the South African government to help, so that we can be treated like ordinary people.” Sazi Mpofu, 30, is one of the hundreds of illegal Zimbabwean refugees who arrived daily in South Africa due to the political and socio-economic crisis in Zimbabwe. He says although he is in the country illegally, he would like to see the government accommodating all refugees regardless of their status. “I want the South African government to know that we are here not because of our will. We love to stay in Zimbabwe because that is where we grew up, that is where we feel happy. We want the government to sit down and debate about this problem (not accessing health care). I don’t think there is going to be much of a problem if the government can allow asylum seekers to have access to health care,” he said. Sox Chikohweru of the Zimbabwe Diaspora Forum says it is sad that as Zimbabweans living in South Africa find themselves being refused access to health care, whereas South African freedom fighters were given all the help they needed when they were in foreign countries during the struggle against apartheid. He says as a freedom fighter himself, he remembers how his father used to help South African freedom fighters regardless of their refugee status. “I am a former freedom fighter myself. My father housed freedom fighters from South Africa in Zimbabwe. All that was needed was an MK card, not a refugee paper, not an asylum paper, not to visit the home affairs for the rest of your life in a foreign country. All that was needed was an MK card. “We are not asking for more, but we want them to look back and see how they were assisted by other countries and to also do the same for us, not only for us (Zimbabwe refugees), but all refugees in South Africa,” he said. Lauren Landau, Director of the Wits University-based, National Consortium for Refugees Affairs says the country’s Constitution allows refugees and asylum seekers access to health care. However, **__lack of knowledge of health professional about the rights of refugees as well as xenophobic discrimination against refugees make it difficult for refugees to access health care.__** “Refugees who are legally recognized by the South African government have the same rights to health care as any South African citizen or a permanent resident. People who are asylum seekers - those are the people who have applied to be refugees, but who have not yet been recognized - have limited rights and have to pay some fees. But everyone in South Africa whether they are asylum seekers or refugees have rights to emergency or life saving care. “**__There is also a real problem of health care professionals who are not aware of the rights that migrant refugees have to the services. There are also instances where there is outright discrimination, where people are told to go away, that ‘these are our resources. We do not have enough resources for foreigners, for people who are not South African’,” he added. Meanwhile, the health department spokesperson__**, Sbani Mngadi says, “Iif there is a need for an emergency health care, we do not deny anyone access. We can then deal with the illegal issues in conjunction with the department of Home Affairs. But **__we need to make it clear that people who have refugee status, permanent and non-permanent residents, need to get same level of health care__**.” 


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**D**.
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Refugee Camps are pathogenic environments that can be prevented with proper health care aid.  

Doctors Without Borders/ Medecins Sans Frontiers (MSF), Intl. Medical Humanitarian Organization No Date 
http://www.refugeecamp.org/degrade/shelter/index2.html 

A poorly planned refugee settlement is one of the most pathogenic environments possible. Overcrowding and poor hygiene are major factors in the transmission of diseases with epidemic potential (measles, meningitis, cholera, etc.). The lack of adequate shelter means that the population is deprived of all privacy and constantly exposed to the elements (rain, cold, wind, etc.). In addition, the surrounding environment may have a pronounced effect on refugee health, particularly if it is very different from the environment from which they have come (e.g. presence of vectors carrying diseases not previously encountered).  
Camps usually present a higher risk than refugee settlements in open situations as there is more severe overcrowding, and less likelihood that basic facilities, such as water supply and health care services, will be available when refugees first arrive. Relief work is more difficult to organize for very large camp populations, such as some of the Rwandan refugee camps in Zaire (Goma, 1994) which contained more than 100,000 refugees. 
In order to reduce health risks, it is essential that site planning and organization takes place as early as possible so that overcrowding is minimized and efficient relief services are provided. Shelters must be provided as rapidly as possible to protect refugees from the environment, and infrastructure installed for the necessary health and nutrition facilities, water supply installations, latrines, etc. All this must be initiated within the first week of intervention. 
Relief agencies are usually faced with one of two possible situations: either the camp is already established with a refugee population that has spontaneously settled on a site prior to the arrival of relief agencies, or site planning is possible prior to their arrival, for example, when they are being transferred to a new camp. 
Whichever is the case, prompt action must be undertaken to improve the site and its-facilities; poor organization in the early stages may lead to a chaotic and potentially irreversible situation in regard to camp infrastructure, with consequent health risks. For example, lateral expansion of a site must be accounted for from the beginning in order to avoid overcrowding if refugee numbers increase.  